tbuckley/cabot-search huggingface dataset:
AB0711 VASCULAR CALCIFICATIONS IN LARGE VESSEL VASCULITIS
Authors: C. Marvisi, R. Farì, G. Besutti, L. Spaggiari, P. Mancuso, F. Muratore, E. Galli, P. Pattacini, C. Salvarani
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Arterial wall calcifications are a hallmark of atherosclerosis and represent an important cardiovascular risk factor. Accelerated atherosclerosis and vascular calcifications have been reported in large vessel vasculitis (LVV), but data are scarce about the amount and localizations [1]. <h3>Objectives</h3> The aim of this study was to compare the prevalence, amount, and local distribution of arterial wall calcification evaluated on CT scan in LVVs versus lymphoma patients matched for age, sex, and year of diagnosis. <h3>Methods</h3> All consecutive patients diagnosed at our institution with LVVs from 2007 to 2018 with an available baseline PET-CT scan were included. Lymphoma patients were matched based on age, sex, and year of baseline PET-CT. CT images derived from baseline PET-CT scans of both patient groups were retrospectively reviewed by a single radiologist who, after setting a threshold of minimum 130 HU, semi-automatically computed vascular calcifications in three separate sites (coronaries, thoracic and abdominal arteries), quantified as Agatston, volume and mass scores. Calcifications in the two groups were compared for each site by using paired T-test. The effect of patient group was evaluated on the presence of calcifications in each site by means of adjusted conditional logistic regressions, and on the score of thoracic calcifications by means of adjusted regression. <h3>Results</h3> 258 patients were enrolled, including Takayasu's arteritis n=57, giant cell arteritis n=72 and lymphoma n=129. Thoracic artery calcifications were more represented in LVV patients, when compared with lymphoma patients (mean volume 2026 in LVVs vs 1014 in lymphomas, p=0.054). Coronary calcifications were higher in lymphoma patients (mean volume 104 in LVVs and 198 in lymphomas, p=0.13), whereas abdominal artery calcifications were equally distributed (mean volume 3220 in LVVs and 2712 in lymphomas). A diagnosis of LVV was associated with the presence of thoracic calcifications after adjusting by age and year of diagnosis (OR=4.13, 95%CI= 1.35-12.66; p=0.013), and with the volume score in the thoracic arteries (p=0.048). <h3>Conclusion</h3> When compared with lymphoma patients matched by age, sex, and year of diagnosis, LVV patients have higher calcification in the thoracic arteries, but not in coronary and abdominal arteries. <h3>References</h3> [1]Banerjee S. et al. Semin Arthritis Rheum 2020 <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
AB0734 POLYPHARMACY AND COMORBIDITIES ARE NOT INCREASED AT DIAGNOSIS IN PATIENTS WITH POLYMYALGIA RHEUMATICA
Authors: M. A. Cimmino, E. Hysa, P. Clini, D. Camellino
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Polypharmacy, the prescription of multiple drugs for an individual patient, is increasing especially in ageing individuals with comorbidities. Polymyalgia rheumatica (PMR) is an inflammatory disease of the elderly causing pain and stiffness in the girdles. A recent systematic review showed that cardiovascular disease and lymphoproliferative disorders could be possibly increased in PMR patients, but the quality of the included studies was relatively poor. In addition, some comorbidities could be caused by PMR treatment and not by the disease itself. <h3>Objectives</h3> Our study is concerned with an evaluation of polypharmacy and comorbidities in PMR patients at diagnosis. <h3>Methods</h3> Patients were enrolled if they fulfilled the 2012 EULAR/ACR provisional criteria for PMR. Sex and age-matched controls were patients with hand OA diagnosed according to the 1990 ACR clinical criteria and seen in the same private outpatient clinic as patients. Both groups were interviewed at the time of diagnosis for the type and number of assumed drugs and comorbidities by the same investigator. The rheumatic diseases comorbidity index (RCDI) was used. <h3>Results</h3> 83 PMR patients (median 75 years, range 50-88 years, 65.1% women) and 83 controls (median 72 years, range 53-90 years, 65.1% women) were studied. Median disease duration was 2 months (0.3-8 months) and median glucocorticoid dose before assessment was 0 mg (0-750 mg). The mean number of drugs assumed by PMR patients was 2.5±2.1 in comparison with 3.0±2.2 of controls (p=0.129). PMR patients with hip pain assumed less drugs (2.1±1.8 vs. 3.7±2.3, p=0.008) and those with morning stiffness &gt;45 minutes assumed more drugs (2.8±2.1 vs. 2.8±2.1, p=0.001). The mean RDCI was 1.58±1.29 in PMR patients and 1.45±1.36 in controls (p=0.52). The frequency of the individual comorbidities in PMR patients and controls is reported in Table 1. No difference was observed in cancer type. Number of assumed drugs and RDCI significantly correlated (r=0.58; p&lt;0.001), and both were directly associated with age (p&lt;0.001). At multiple logistic regression, with number of assumed drugs as dependent variable and variables which showed in univariate analysis p&lt;0.1 as independent ones, age (p=0.007) directly, whereas hip pain (p=0.006) and fever (p=0.014) indirectly predicted number of assumed drugs. With RDCI as dependent variable, age (p=0.04) and WBC (p=0.02) directly, whereas fever (p=0.019) indirectly predicted RDCI. <h3>Conclusion</h3> When considered at the time of diagnosis, PMR patients do not show an increased comorbidity index nor number of assumed drugs in comparison with OA controls. Only gastric disease was lower, possibly due to the increased NSAIDs use in OA patients. <h3>REFERENCES:</h3> NIL. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
AB0753 EFFICACY AND SAFETY OF TOCILIZUMAB IN PATIENTS WITH VASCULITIS
Authors: J. Luo, Q. Y. Su, Q. LI, Y. Zhang, X. Y. LI, X. Zhang, Y. Ren, Q. Yu, P. F. He, X. LI, S. X. Zhang
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Vasculitis is characterized by inflammation of blood vessels, leading to potential long-term sequelae, including vision loss, aneurysm formation, and kidney failure. Large vessel vasculitis encompasses Takayasu arteritis and giant cell arteritis, which cause inflammation of the aorta and its major branches. Tocilizumab, a humanized monoclonal antibody against the interleukin-6 receptor, has been associated with rapid induction and maintenance of remission in patients with vasculitis. <h3>Objectives</h3> This study aimed to systematically evaluate the efficacy and safety of tocilizumab therapy in vasculitis. <h3>Methods</h3> Eight databases (PubMed, Web of Science, Embase, Cochrane Library, Web of Knowledge, MEDLINE, Clinical Trials.gov, and FDA.gov) were searched for studies on tocilizumab treatment of vasculitis published from the date of establishment of the database to January 1, 2023. We used Stata 12.0 software to conduct a meta-analysis of the efficacy and safety of tocilizumab in patients with vasculitis using a random effect model. <h3>Results</h3> A total of 8 studies with a total of 823 patients were included. Either doses 162mg/week or 8mg/kg/4weeks, compared with placebo, tocilizumab significantly both promoted remission of vasculitis(RR=0.909, 95%CI: 0.768-1.075, P&lt;0.001; RR=0.639, 95%CI: 0.410-0.994, P&lt;0.042)(Figure 1A). No significant difference was observed in the probability of disease relapse in subgroup analysis based on different diseases(Figure 1B). In subgroup analysis based on dose, 8mg/kg/4 weeks doses significantly reduced the probability of disease relapse (RR=0.639, 95% CI: 0.410-0.994, P=0.047)(Figure 1C). The results of subgroup analysis about the rate of adverse events (AE) and serious adverse events (SAE) according to different diseases and different doses, our meta-analysis found that there was no statistical significance between tocilizumab and placebo(Figure 1E-H). It demonstrated the safety of tocilizumab therapy in vasculitis treatment. <h3>Conclusion</h3> Tocilizumab treatment was effective and well-tolerated in vasculitis patients. <h3>Acknowledgements</h3> This work was supported by the National Natural Science Foundation of China (No. 82001740). <h3>Disclosure of Interests</h3> None Declared.
AB0744 HYPERTENSION AND AGE ARE RISK FACTORS FOR VISUAL IMPAIRMENT IN GIANT CELL ARTERITIS
Authors: F. Regola, J. Mora, F. Franceschini, P. Toniati
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Permanent vision loss is a feared complication and a leading cause of morbidity in Giant Cell Arteritis (GCA). Prompt recognition of patients with visual manifestation is fundamental to reduce permanent vision loss occurrence. <h3>Objectives</h3> The study aims to evaluate risk factors for visual manifestations at disease onset in an Italian monocentric cohort of patients with Giant Cell Arteritis (GCA). <h3>Methods</h3> We identified 128 patients with GCA diagnosed between 2011 and 2021 in our Center. All patients were older than 50 years of age, met the 1990 ACR criteria for GCA or had a positive temporal artery biopsy or ultrasound. Medical records of all patients were reviewed and demographic, clinical, and laboratory data were collected. <h3>Results</h3> Fifty-five patients (43%) presented at diagnosis visual ischemic manifestations: blurred vision in 6 pts, diplopia in 6 pts, amaurosis fugax in 5 pts, partial visual loss in 23 pts and complete vision loss in 1 or 2 eyes in 12 and 3 pts respectively. Out of 38 patients with partial or complete visual loss, 36 presented Arteritic Anterior Ischemic Optic Neuropathy (AION), and 2 presented Central Retinal Artery Occlusion (CRAO). Patients with visual manifestations had a median age of 77 (IQR 73-81) years, significantly older if compared to patients without ocular symptoms (72 (67-76) years, p&lt;0.001). Patients with ocular involvement presented more often hypertension (67 vs 44%, p: 0.009) and chronic kidney disease (7 vs 0%, p: 0.031) as comorbidity at diagnosis, while no differences were found in diabetes, cancer, coronary heart disease and dyslipidemia incidence comparing patients with and without visual manifestations. No associations between visual impairment and other cranial symptoms (headache, jaw claudication, scalp tenderness) were found, but peripheral arthritis was negatively associated with ocular manifestations. No laboratory variables were associated with ocular involvement. <h3>Conclusion</h3> In this large cohort of patients with GCA, partial or complete visual loss were the most frequent visual manifestations. No associations between ocular involvement and other cranial symptoms were found, while patients with peripheral arthritis had a lower risk of developing visual impairment. Age and hypertension at disease onset seem to be the most important risk factors for visual ischemic manifestations in GCA patients. <h3>References</h3> [1]Liozon E et al. J Rheumatol 2016. [2] Baalbaki H et al. Clin Rheumatol 2021. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
AB0836 ANTI-SAE ANTIBODY-POSITIVE DERMATOMYOSITIS: CLINICAL CHARACTERISTICS FROM AN ITALIAN COHORT
Authors: R. Depascale, A. Ghirardello, E. Zanatta, M. Gatto, M. Zen, L. Iaccarino, A. Doria
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Anti-small ubiquitin-like modifier-1 activating enzyme (anti-SAE) antibodies are rare myositis-specific antibodies, which are mainly associated with cutaneous involvement in inflammatory myositis (IIM). <h3>Objectives</h3> To analyse clinical characteristics of anti-SAE positive Dermatomyositis (DM) patients in a monocentric cohort. We focused on clinical manifestations and type of organ involvement. <h3>Methods</h3> In a monocentric cohort of 169 patients with IIM, anti-SAE antibody positive patients were included in the study. Anti-SAE antibodies were investigated by immunoblotting. We considered the presentation symptoms at disease onset and during follow-up, focusing on musculoskeletal, cutaneous and pulmonary domains. Muscular involvement was evaluated by Manual Muscle Test-8 and creatin kinase (CK) levels. To determine interstitial lung disease (ILD), high-resolution computed tomography (HRCT) was performed at diagnosis and during follow-up and evaluated by an expert radiologist. Skin and joint involvement was evaluated by clinical judgment. Therapeutic approach was also considered. <h3>Results</h3> Of the 169 patients with IIM, 6 were positive for anti-SAE antibodies (3,5%). Among them, five were female and one male. The mean age at onset of symptoms was 46.3 years (range 5-78 years). Cutaneous manifestations were the most prevalent clinical features at disease onset. Indeed, all of the patients had photosensitive rash, heliotrope rash and Gottron papules. Mechanic's hands were noted only in one patient with ILD. Four (70%) had arthritis. Muscular involvement, which was mostly mild, was evidenced by muscular weakness and high levels of CK (mean value 538 U/l) in 30% of patients (n=2). Three patients (50%) had radiological evidence of ILD at onset or during follow-up. Non-specific Interstitial Pneumonia (NSIP) was the main pattern found. Story of malignancy was noted only in the male patient. Half of the patients (n=3) were treated with methotrexate (MTX). Because of drug intolerance, MTX was substituted by mycophenolate mophetil (MMF) in two of them. One patient received intravenous immunonoglobulin (IGIV) and cyclophosphamide (CYC) for persistent cutaneous disease activity. <h3>Conclusion</h3> In our small cohort of patients, anti-SAE antibodies were strongly associated with skin disease, in one case severe. Lung involvement was another common clinical feature described and malignancy was noted in one case. <h3>REFERENCES:</h3> NIL. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
AB0685 DESCRIPTIVE STUDY OF A COHORT OF PATIENTS WITH NEUROPSYCHIATRIC MANIFESTATIONS IN SYSTEMIC LUPUS ERYTHEMATOSUS IN A TERTIARY HOSPITAL
Authors: R. J. Gil Velez, L. Mendez Diaz, I. Madroñal García
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Systemic lupus erythematosus (SLE) affects 0.1% of the world population; its neuropsychiatric expressions include, from vascular headache, mood disturbances to cognitive and other severe disorders such as transverse myelitis. It represents a diagnostic challenge, since none of the syndromes is exclusive of SLE and up to 40% is attributed to other causes; specifically it is necessary to rule out central nervous system infection, uremia, thrombotic thrombocytopenic purpura, posterior reversible encephalopathy, steroid psychosis and hypertension. <h3>Objectives</h3> To describe the neurological/neuropsychiatric manifestations in patients with systemic lupus erythematosus, diagnostic tests used and therapeutic possibilities in a cohort of patients in a tertiary level hospital. <h3>Methods</h3> Retrospective descriptive study of a cohort of patients with neuropsychiatric manifestations in the context of SLE in the Rheumatology Department of the Hospital Universitario Virgen del Rocio Sevilla (2017-2022). <h3>Results</h3> 12 patients with neuropsychiatric manifestations were included in our study, 8 (66.6%) women, 4 (33.4%) men, with a mean age of 30 ± 6 years and mean time of diagnosis of systemic lupus erythematosus of 3.5 years. Nine (75%) SLE with joint/cutaneous involvement and 3(25%) SLE with renal involvement (focal proliferative glomerulonephritis and segmental). In 9 (75%) of the cases imaging studies both cranial MRI and PET showed inconclusive lesions and as for specific antibodies: 4 (33.3%) anti-NMDAR, 3 (25%) anti-ribosome P. Among the most frequent clinical manifestations 6 (50%) presented persistent headache, 3 (25%) psychosis, 3 (25%) memory and mood disturbances. 9 (75%) of the cases responded to anti-CD20 (rituximab) and 3 (25%) to intravenous immunoglobulin infusion. <h3>Conclusion</h3> The data obtained from the clinical histories were conclusive with current scientific publications. It is an entity whose diagnosis is a challenge for the clinician, and both analytical tests and imaging studies are usually non-specific. The most frequent manifestations are headache, cognitive manifestations and mood alterations (anxiety attacks, panic, euphoria). Further studies are needed to classify the risk of this entity and the relationship with specific neuronal autoantibodies. <h3>REFERENCES:</h3> NIL. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
AB1135 CHARACTERIZING THE MINIMAL DISEASE ACTIVITY DOMAINS ACHIEVED BASED ON DIFFERENT TREATMENTS.
Authors: S. Scriffignano, F. M. Perrotta, M. Fatica, P. Triggianese, P. Conigliaro, M. Ferraioli, M. S. Chimenti, E. Lubrano
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Minimal Disease Activity (MDA) is a validated treatment response index for Psoriatic Arthritis (PsA). A status of MDA is reached when 5/7 domains are achieved. Even if MDA is worldwide used, both in clinical trials and in clinical practice, nowadays there are no studies that evaluated any differences in the MDA domains achievement based on various treatments. <h3>Objectives</h3> To characterize the MDA domains achieved based on treatment; to assess which treatment is associated with a higher probability to reach MDA status in clinical practice. <h3>Methods</h3> This is a cross sectional analysis of two longitudinal PsA cohorts. Inclusion criteria were: age ≥18 years, PsA diagnosis for at least 12 months, stable treatment for at least 6 months. Patients were grouped depending on the therapy: group 1: NSAIDs or COX2i or steroids, group 2: csDMARDs, group 3: TNFi, group 4: anti-IL 12-23 or 23, group 5: anti-IL17A, group 6: PD4i. For each group, MDA domains based on therapy were assessed. Logistic regression analysis was performed to assess the association between the treatment groups and the achievement of the MDA, independently by others confounding factors. <h3>Results</h3> Patients enrolled were 220. MDA was achieved in 45.8% of patients. In all treatment groups, the first three MDA domains more achieved were: BSA ≤3, SJC ≤1 and LEI ≤1, instead, in all groups (excepted for the PD4i) the MDA domains less frequently achieved were PtGA ≤2 cm and pain on VAS ≤1.5 cm (Table 1). Moreover, the logistic regression analysis showed a higher probability to achieve MDA for those patients in group 3 and 4 when compared with group 1, independently by age, sex and disease duration (Table 2). <h3>Conclusion</h3> In each treatment group, the MDA domains less frequently achieved were PtGA and pain, suggesting that the patient driven domains are still an unmet need. Moreover, the probability to achieve MDA status is higher in patients in group 3 and 4. However, larger and prospective studies needed to confirm these preliminary results, including also the newest therapies recently adopted for PsA. <h3>Reference</h3> [1]Coates LC, at al. <i>Ann Rheum Dis</i>. 2010;69(1):48-53. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> silvia scriffignano: None declared, Fabio Massimo Perrotta Speakers bureau: Lilly, Novartis, AbbVie, Mauro Fatica: None declared, Paola Triggianese: None declared, Paola Conigliaro: None declared, Mario Ferraioli: None declared, Maria Sole Chimenti: None declared, Ennio Lubrano Speakers bureau: Lilly, Pfizer, AbbVie, Novartis, Janssen, Amgen, Consultant of: Lilly, Pfizer, AbbVie, Novartis, Janssen, Amgen.
AB0915 A STUDY ON THE ASSESSMENT OF CARDIOVASCULAR RISK AND CIMT IN PATIENTS OF SYSTEMIC SCLEROSIS AND CORRELATION OF CIMT WITH QRISK 3 AND DISEASE SEVERITY SCORE
Authors: P. Dogga, K. Chandwar, K. Kishor, D. Ekbote, J. Dixit, U. Dhakad, P. Kumar
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Accelerated atherosclerosis is well-known in connective tissue disease however is less reported in Systemic Sclerosis. There is evidence that atherosclerosis occurs prematurely in Systemic sclerosis. The micro vascular disease is characteristic of SSc, but there is growing evidence of macro vascular disease in SSc patients. Several studies have evaluated the prevalence of atherosclerosis in carotid arteries in patients with SSc by ultrasonography. Increased CIMT and conventional CVD risk factors have well known association with future events of stroke and coronary heart disease. <h3>Objectives:</h3> 1.To study the Cardiovascular risk and Carotid Intima medial thickness in patients of Systemic sclerosis and their correlation 2.To assess the Disease Severity by using MEDS score and its correlation with CIMT <h3>Methods</h3> Data of 72 patients including clinical, serological profile and treatment were recorded. Cardiovascular risk by QRISK 3 calculator, CIMT by Ultrasonography are used. Correlation between Cardiovascular profile with CIMT and disease severity were seen. Medsger disease severity score was used to estimate the disease severity. Thirty-four age comparable controls were included. <h3>Results</h3> A total of 72 SSc patients (lcSSc -27, dcSSc -45) were included in the study. F&gt; M (11:1). The median duration of disease enrolled was 2.9 years and time to referral to a specialist was 1.28 years. On patient in our study developed Scleroderma renal crisis and one patient was diagnosed with Adenocarcinoma of lung. Lipid profile showed low HDL, high LDL, TG, Cholesterol as compared to controls. The mean CIMT of the patients showed a significant difference when compared to controls (0.58± 0.09 <b>vs</b> 0.56 ±0.10; p=&lt;0.01).The mean mRSS was 23.99±10.44 and mean MEDS score was 8.68±2.76. Forty-three patients (59.7%) out of 72 had ILD documented by HRCT. NSIP in 22 (30.6%) and UIP in 21 (29.2%) patterns on HRCT were observed. The Severity of PAH (Mpap &gt;20 mm Hg) is greater in lcSSc vs dcSSc (30.33±10.50 vs 28.42 ± 7.38). Cyclophosphamide, MMF were used as induction therapies mainly for treatment of ILD. The mean CIMT (0.58± 0.09) showed a significant positive correlation with QRISK3 however it is weak with rho=0.575, p value &lt;0.001. The mean CIMT (0.58± 0.09 mm) showed a negative correlation with mRSS with rho = -0.145 and p value 0.224. <h3>Conclusion</h3> CIMT had positive correlation with PAH (significant, p=0.034) and QRISK3 (significant, p=&lt;0.01). CIMT had negative correlation with mRSS. The mean CIMT showed no correlation with MEDS score. <h3>REFERENCES:</h3> NIL. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.